Distinction of Ventricular Fibrillation and Ventricular Tachycardia

Using Cross Correlation

J Ruiz, E Aramendi, S Ruiz de Gauna, A Lazkano,LA Leturiondo, JJ Gutiirrez
University of the Basque Country,Bilbao, Spain
and VT by complex measure [41.
Chen et al. have already proposed the analysis of the
ECG signal autocorrelation function and the application
of a regression test to the resultant positive peaks to
discriminate VFNT rhythms [5].
Our work presents a VFNT discrimination method
based on the analysis of the cross correlation function
between two segments of the same ECG signal.

Abstract
The accurate discrimination of ventricular
tachycardia (VT)
from ventricularfibrilhtion (VF) is an
important issue in Automated External Defibrillator
(AED) and other cardiac monitoring systems. The
correlation function of the ECG signal is an adequute
tool for detecting irregularities or noise in signals.
Therefore, methods for VFNT discrimination based on
the autocorrehtion of the ECG signal and on the cross
correlation of the ECG signal with different remphtes
have been proposed. Our work is focused on the use of
the cross correlation of the ECG signal with a segment of
the same ECG signal, instead of using a given template.
The developed algorithm hns been tested on a
database consisting of 179 human VF and 74 human VT
records. The new algorithm classifies accurately 313 VF
windows (90.2% sensitivity) and 179 VT windows
(96.7S% sensitivity). These results improve those
obtained from other techniques, considered as a
reference,for the same records database.

1.

Ventricular fibrillation and ventricular tachycardia are

both life-threatening cardiac arrhythmias. Regarding to
the functionality of AEDs or other similar devices, it is
dramatically important to quickly discriminate between
both rhythms, as VT can be terminated by cardioversion,
delivering low energy shocks in synchronization with the
heart beat, whereas VF requires high-energy
defibrillation shocks.
In the last ten years, many algorithms based on time or
frequency domain, or on combined techniques have been
proposed to automatically discriminateVF from VT. both
for external and for implantable devices.
In the first case, Thakor et ai. developed a sequential
detection algorithm based on the average threshold
crossing intervals [I]. Another technique also based on
sequential algorithm was proposed by Chen et al. [2, 31.
It tries to measure the time irregularity of the cardiac
rhythm through the characteristic referenced as Wanking
variability independently from the cardiac frequency.
Zhang et al. have designed a method for detecting VF

ii.oue2003

IEEE

Materials and methods

2.1.

VFNT records database

The designed algorithm has been developed and tested

on a VF and VT rhythms database. It consists of 179
records belonging to cardiac rhythms classified as VF and
of 74 records belonging to VT rhythms, all of them
recorded from surface ECG signals. The records source
has been the MIT (Massachusetts Institute of
Technology) and the AHA (American Heart Association)
databases, the Electrophysiology Department of the
Basurto Hospital in Bilbao (Spain) and also several
rhythms registered by the Emergency Services using
Life-Pack 12 and Life-Pack 500.
The algorithm applies a signal window of 4.8 seconds.
Therefore, the 179 VF records contain 347 windows of
4.8s. considered VF, and the 74 VT records contain 185
VT windows.
All the signals have been preprocessed by a bandpass
filter (0.7 - 35Hz) in order to suppress DC components,
baseline drifts and possible electrical network
interference.

Introduction

u276-6547m3

2.

2.2.

Cross correlation method

A VF rhythm has more irregular frequency and

amplitude patterns than a VT rhythm. In general, all the
VFNT discrimination methods try to evaluate the ECG
signal regularity in order to classify it as VF or VT.
In this work, we propose the use of the cross
conelation of two parts of ECG signal to evaluate its
regularity. The starting point is an ECG preprocessed
signal with a duration of 4.8s (N samples). s[n]; the first
0.6 seconds (L samples) of s[n] is taken as the reference
signal, y [ n ] ; the second part of 4.2s (M samples of s[n])
constitutes the base signal to measure the regularity of
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Computers in Crrdiolagy 2003;30:729-732

s[n]. By this way:

y[n1

n = O ...L - l

x[nl

n = O ...M - l

=
=

n=O ...L-1
n=L..N-I

s[n]

s[n1

The regularity of the signal is evaluated by the cross

correlation of xlnl with regard to the signal reference
y[n], and is calculated through the next expression:
"+L

rv[nl=x

n = O ...M - L

x[ml.y[m-nl

(1)

Figure 2. Example of a VT signal window (the reference

segment is remarked) and the cross correlationfunction.

In="

In order to make the value of the cross correlation

independent from the energy level of the starting ECG
signal, the expression (1) is normalized in relation to the
reference signal energy. Therefore, the cross correlation
which has been used to evaluate the regularity of the
ECG signal is given by the next expression:

2.3.

To quantify the irregularity of the analyzed signal

window, three significant parameters are considered from
the function r d n ] .
The first parameter is the number of positive peaks of
the cross correlation function. They will only be
considered those that exceed a threshold, established in
the 10% of the reference signal energy.
On the other hand, the distance between two
consecutive peaks gives a measure of the cardiac
frequency in that interval. The standard deviation of the
cardiac frequencies, measured in beats per minute (bpm),
of each window of 4.8s, is the second parameter, sr4. For
a signal window corresponding to a VF record, it is
expected a higher srdf value, compared to the calculated
for a VT window.
Finally, it has been obtained the standard deviation of
the peak amplitudes for each window, sfda. Again, for a
VF window, the expected stda value is higher than for a
VT window.

"tL

z xlml.y[m-nI
r,[nI=

n = O...M- L

m=n

(2)

r2[m1

m=O

If the ECG signal sin] were perfectly periodic, r,[n]

would present positive, equally spaced and with the same
amplitude peaks.
Two examples corresponding to a window of a VF
signal and a VT signal are presented in Fig. I and 2,
respectively. It is observed that the distribution and the
amplitudes of the cross correlation peaks are more
uniform in a VT than in a VF signal.

2.4.
P a o r m o n 3 n n d a M ( E C O U(".l

9.f.""'.

With the purpose of discriminate quickly those signal

windows too much irregular, it has been decided that if
the number of peaks is less than 8. the window is
classified as VF.
For the rest of the signals, it has been studied the
probability distribution of the standard deviations of the
cardiac frequencies and the peak amplitudes, srdf and
st&, respectively. Analysing these distributions and
focusing on the different results obtained for the VF and
the VT windows, discriminationcriteria can be based just
on these differences.
Fig. 3 presents the Probability Distribution Function
(PDF) of the sfdfparameter for the VF and VT windows.

05
~

......

....... .....
~

DI

I
05

IS

25

Discrimination algorithm

rg~l,,m*.d

II

Significant parameters

I
36

15

Figure 1. Example of a VF signal window (the reference

segment is remaxked) and the cross correlation function.

730

4I

Figure 3. Probability Distribution Function of the

standard deviation of the cardiac frequencies.

Figure 4. Probability Distribution Function of the

standard deviation of the peak amplitudes.

In the PDF corresponding to VT rhythms, it can be

seen that the srdf parameter only exceeds the value 10 in
few cases, whereas for VF rhythms, only few cases
appear under the value 10.
Fig. 4 presents the PDF of the srda parameter for all
the VF and VT windows. Again it is observed the
relevance of this parameter for discriminating VFNT
rhythms.

Finally, a scatter diagram of srdfand srda is shown in

Fig. 5. From this distribution, we have defined the
significant thresholds for the design of the VFNT
windows classification algorithm.

731

Testing this algorithm on the same VFNT database,

worse discrimination results have k e n obtained: 303
windows classified as VF from the total of 347 (87.31%
sensitivity) and 167 windows classified as VT from the
total of 185 (90.27%) sensitivity).

Scatter Diaenm: stdfnstds

. ..

TI

10

Ral

4.

A VFNT discrimination algorithm has been designed,

based on the analysis of the cross correlation function
between segments of the same ECG signal. The
algorithm testing on the VFNT rhythms database has
resulted in better VF and VT sensibilities, improving
those obtained from other reference methods. Despite of
these satisfactory results, it is necessary to remark that the
algorithm has been adjusted on the same test database.
As an important achievement, this method provides
two parameters to face the VFNT discrimination: one of
them is linked to the cardiac frequency uniformity along
the analysis window, and the other is related to the signal
amplitude uniformity along the signal window.

*tLU

Figure 5. Scatter diagram of stdf and srda. VF

occurrences are marked "+" and VT occurrences are
marked "o".
The next chart represents the developed decision
algorithm:

Acknowledgements
The authors would like to thank Osatu Sociedad
Cooperativa for its financial contributions to this study.

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References
[I] Thakor NV, Zhu YS,Pan KY. Ventricular tachycardia and
fibrillation detection by a sequential hypothesis testing
algorithm. EEE Transactions on Biomedical Engineering
1990;37837-43.
[2] Chen SW. Clarkson PM, Fan Q. A sequential technique for
Journal
of
cardiac arrhythmia discrimination.
Electrocardiology l995;28:162.
[3] Chen SW, Clarkson PM, Fan Q. A robust sequential
detection algorithm for cardiac arrhythmia classification.
IEEE Transactions on Biomedical Engineering
1996;431120-5.
14) zhang xs, mu YS. Thakor NV. Wang ZZ. Detecting
ventricular Tachycardia and fibrillation by complex
measure. EEE Transactions on Biomedical Enaineering
1999;46548-55.
[SI Chen S. Thakor NV. Mower MM. Ventricular fibrillation
detection bv a remssion test on the autocorrelation
function. Medical & Biological Engineering Conference
1987;25:241-9.

VT

Figure 6. VFNT discrimination algorithm.

3.

Conclusions

Results

Once the algorithm is applied to the VFNT database,

VT windows have been
correctly classified, thus obtaining a sensitivity of
90.20% for VF rhythms and a sensitivity of 96.75% for
VT rhythms.
As a reference method, we have applied a variation of
the regression test on the autocorrelation function
proposed in IS] by Chen et al.

Address for correspondence.

313 VF windows and 179

le& Ruiz

Department of Electronics and Telecommunications

Engineering School of Bilbao
Alameda Urquijo. dn
48013-BILBAO(Spain)
E-mail address: ttoruoii@bi.ehu.cs

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